There's something horribly Victorian about the phrase "maternal mortality" - the idea that giving birth is still, routinely, a life-threatening activity. But
the risk of death that women face during pregnancy, delivery and the weeks that follow remains one of the world's great health problems, even after almost 25 years of initiatives designed to eradicate it.
So the findings of a study by the Institute for Health Metrics and Evaluation (IHME) - that global maternal mortality fell by 35 per cent, or more than 150,000 deaths a year, between 1990 and 2008 - are cheering. Even if they are also, by the admission of the institute's director, Christopher Murray, "quite surprising". The drop from more than half a million annual deaths in 1990 to 343,000 in 2008 (which, put like that, somehow doesn't sound quite as impressive), throws up some definite patterns.
For a start, the world's total fertility rate - the number of children women have - has dropped considerably. Income per capita is rising, especially in Asia and Latin America, so mothers-to-be have greater access to health care and, on the whole, are eating better. (It's been suggested that the failure to improve maternal mortality ratio - MMR - in the UK may be partly due to rising obesity, although the numbers involved are extremely low: eight per 100,000 births.)
Also, access to education is improving. In sub-Saharan Africa, this may mean only 4.4 years of schooling on average; but the improvement from the average period of education in 1980 - a year and a half - is vast. The more frequent presence of midwives also seems to have improved things. But there are negative patterns, too: HIV alone caused more than 60,000 maternal deaths in 2008.
However, while it is clear how HIV affects the numbers (the eradication of the virus, incidentally, sits next to the reduction of maternal mortality on the global to-do list known as the Millennium Development Goals), it is more difficult to identify other important factors. Why, for example, has India improved so much faster than Indonesia? Why is Brazil doing better than Mexico? Although it is evident, if unsurprising, that better diet, health care and education all play a part.
Most of the world is still nowhere near achieving the fifth Millennium Development Goal - reducing the MMR by 75 per cent between 1990 and 2015. According to the IHME report, only 23 countries look likely to do so - and as it is based on data up to 2008, the recession's effect on development funding has yet to be mapped. But the institute's findings raise hope that high levels of maternal mortality might, at some point, become a thing of the past. It's encouraging to have so many indications of how to make that happen.